| NPI | 1396286837 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MISTI TIENDA Office Manager 806-894-6830 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: TX 18668) |
| Enumeration Date | 2017-03-16 |
| Last Update Date | 2017-03-16 |